The chief tells the gang that the residents are now attendings. Cristina is having a hard time with the change.

Karev’s new patient comes out and has man boobs. He’s just a teenager and wants to get surgery to get rid of them, but his mom thinks it’s not necessary. After spending some time with the kid, Karev tells her that he thinks she should listen to what her son wants. She finally agrees to it.

The surgery goes smoothly and Karev does  an excellent job. The young boy no longer has boobs.

Cristina’s patient, Roy, needs a new lung because he can’t breathe. Teddy tries to coach her, but it’s not going very well.

Teddy tells Cristina that she better start participating otherwise she’ll recommended to the Chief to drop her from the program. April tries to talk to Cristina about what to do with the patient, but she refuses to be apart of what’s going on with anything.  

Cristina eventually tells April that she knows exactly what’s happening. Roy will die. After meeting again with Roy, Cristina reevaluates the situation and realizes that Roy has the will to live. With her opinion the board decides to go thorough with giving Roy the transplant he needs to live.

Teddy meets with the Chief to get him to donate money to her cardio program to eliminate heart disease though stem cell research.   

Lexie’s patient doesn’t think she’s qualified until she goes through her charts perfectly off the top of her head. She is fine all day until she starts coding. Meredith comes in and realizes that she has bleeding in the brain and needs an OR right away.

Derek is too busy with the patient that Jackson messed up to come help Meredith with her surgery. Meredith is flying solo. She does an excellent job all by herself.

Owen meets with the Chief to talk with him about the importance of having the doctor’s in the hospital know what to do in the circumstance of emergency training. He uses Charles’ death under Bailey’s watch as an example.

Later, Mark meets with the Chief to talk to him about using the money to expand the burn unit and plastic surgery angle of the hospital.

Arizona meets with the Chief to talk about using the money for peds and they both hesitantly sit there waiting for what will happen next. She tells him that Callie thinks she’ll break down and cry.

Callie meets with the Chief to get him to invest in a program to help athlete’s with leg problems.

She also tells the Chief that Arizona is better in everything, being a lesbian, being nicer, etc. The Chief realizes that Callie is doing this to level the playing ground in her relationship.

Derek talks to the Chief about having a clinical trial for finding a cure for Alzheimer’s because of Meredith.  

Bailey meets with the Chief and tells him that the hospital needs new machines that are broken and another night nurse. The Chief doesn’t understand why she doesn’t come out with something inspirational and Bailey tells him that she’s a realist and a mom. It would be great to daydream about going to Paris, but it’s important to get things done at home and pay the bills.

The Chief makes up his mind to give the million dollars to Owen’s project. Everyone looks disappointed, but happy for him at the same time.

The episode ends with Derek and Meredith heading home. Meredith can’t find the keys in her hand and Derek worries about her.